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International Journal of Health Sciences & Research (www.ijhsr.org) 368
Vol.7; Issue: 5; May 2017
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571
Review Article
Improving Sleep Quality through Heartfulness Meditation- Technical
Aspects and Benefits
Raja Amarnath1, Ghanshyam Verma2, Sugirtha Jenitha3, Chitra Rajan4, Jaya Prasanthi5, Ani Elizabeth6
1Associate professor, Department of Pulmonary Medicine, Director - Critical Care Services, 2Assistant professor, Department of Pulmonary Medicine, In charge of Critical care services,
3Clinical researcher, Critical Care Unit,
Sree Balaji Medical College and Hospital, Chrompet, Chennai-44 4IIT-Chennai, Consultant-Environmental Sustainability
5Dip (Diabetology). 6B.Sc Nursing
Corresponding Author: Raja Amarnath
ABSTRACT
Sleep is a vital function of the body that is essential for our physical and mental well-being. In today’s
world, sleep deprivation is becoming a major epidemic affecting both men and women across all age
groups.
Globalization and explosion of information through Internet, ever increasing competition in this
capitalistic world and endless social engagements have led to an accelerated lifestyle in majority of
the societies, consequently reducing the time to rest and sleep.
Poor sleep affects all ages in terms of attention, concentration, learning, memory, creativity,
productivity, emotional stability and physical health. Inadequate sleep is known to impair health and
shorten the lifespan.
A good quality sleep enhances memory, mood, immune system and fights infection, keeping mind,
heart and blood vessels healthier. Sleep regulates several hormonal functions and autonomic nervous
system and thus improves health.
Currently available drugs to treat sleep disorders have many adverse effects ranging from dependence,
tolerance, day time sedation and risk of Alzheimer’s disease etc. There is a growing interest in
complementary therapies like meditation as an alternative to drugs in this regard.
Meditation has been shown to improve the quality of sleep and also positively affect different medical
conditions that are known to produce sleep disturbances, and thus improves overall quality of life.
Keywords: sleep, insomnia, emotional stress, Heartfulness, Meditation.
INTRODUCTION
If you want to develop yourself,
adjust your sleep patterns, otherwise you
will struggle with this fundamental thing all
your life. You will wake up sleepless and
frustrated and as a result you will create
more and more heaviness within yourself
which affects the way you handle the
worldly matters - Kamlesh D Patel
Sleep is as important as food and
water. It occupies one third of our lives.
Sleep needs vary according to age. Children
sleep twelve hours a day and adults need
about 8 hours. In the modern world this is
simply not feasible. The ever increasing
time pressure due to work from employers,
educational necessities and domestic
responsibilities have led to a constant
decline in sleep hours.
In different studies, approximately
25% of adults mentioned that their sleep
was not satisfactory.10-15% have symptoms
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 369
Vol.7; Issue: 5; May 2017
of sleep deprivation negatively affecting
their day time work. 6-10% met the
diagnostic criteria for insomnia. [1]
Short sleep times have become
habitual for full time workers as most of
them are into long work hours and nightly
work schedules. Chronic shortening of sleep
time has resulted in circadian rhythm
disorders. Sleep problems are also prevalent
among children and teenagers due to all
time availability of computer games,
internet and television. Studies show that
this has resulted in obesity, [2]
cognitive
impairment and emotional disturbances. [3]
In adults, sleep disturbances lead to
a wide range of health problems such as
diabetes, cardio vascular disease, anxiety,
depression, alcoholism and other substance
abuse. [4-7]
Chronic sleep restriction among a
large number of individuals may eventually
impact the society at large in terms of loss
in productivity and increased health costs. [8]
Though research has repeatedly
highlighted the health risks associated with
sleep deprivation and its impact on
behavioural patterns, it appears that society
has accepted these changes as the norm.
In this article we have reviewed the
causes and effects of sleep loss, compare the
similarities and differences between sleep
and meditation and examine whether
meditation can be an option of treatment to
address the needs of sleep deprived
population.
Normal physiology of sleep
SLEEP-WAKE cycle is regulated by two
separate mechanisms.
1. Circadian clock (Process C), also
called the Circadian alerting system,
situated in hypothalamus, works as a
biological clock that controls the
timing of sleep, regulates sleep
patterns and brain wave activity.
2. Sleep- wake homeostasis (Process
S), an internal biochemical system in
brain that controls the accumulation
of endogenous sleep-inducing
chemo transmitters which generates
a homeostatic sleep drive.
Both these mechanisms constantly
interact and balance each other. They are
influenced by genetic factors, ambient
temperature, foods, drugs, alarm clocks,
meal times, exercise, stress, naps, daily
schedules and different mental and physical
disease conditions.
Natural sleep cycle goes through 2 phases.
They are Non Rapid Eye Movement
(NREM) phase and Rapid Eye Movement
(REM) phase. Normally, one starts with a
non REM sleep followed by REM sleep and
then the cycle starts all over again. Dreams
typically occur during the REM sleep.
NREM sleep
There are four phases in Non-REM sleep
Stage 1 –This is a transition period between
wakefulness and sleep, typically lasts for 1
to 10 minutes. Eyes are closed and mind is
relaxed in this stage of light sleep. Electro
Encephalo Gram (EEG) predominantly
shows alpha (α) waves followed by theta
waves (ϑ).
Stage 2 –This is the first stage of real sleep
usually lasts about 20 minutes.EEG
typically shows sleep spindles and K-
complexes.
Stage 3 & 4–This is a deep sleep usually
lasts for 35 to 45 minutes. Body temperature
and blood pressure decreases. Muscle tone
is decreased but most reflexes are intact.
Snoring, bedwetting, sleep-talking and
sleep-walking; generally occur in this stage.
It is difficult to wake up a person from this
stage; if woken up, one generally feels
disoriented for a few minutes. Slow delta (δ)
waves predominate in EEG in this stage.
During this stage, body repairs and rebuilds
tissues, bones and muscles and strengthens
the immune system.
REM sleep
This stage begins approximately 90
minutes after one falls asleep. The first
REM lasts for about 10 minutes and
progressively gets longer in the successive
cycles. Brain is active during this stage and
rapid eye movements will be present. Active
dreaming (dreams are usually remembered)
and active body movements are present but
it is difficult to wake up the person with
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 370
Vol.7; Issue: 5; May 2017
sensory stimulations during this phase.
Decrease in muscle tone (except respiratory
and eye muscles) is present. There will be
irregularity in heart and respiratory rates.
Beta waves (β) predominate in EEG.
Waking up in the morning generally
coincides with the last REM period. REM
stage occupies 50% of total sleep in babies,
compared to only 20% in adults. [9-18]
Studies show gender based
differences in sleep patterns. Men spend
greater time in stage 1 sleep [19]
and
experience more awakenings. [20]
Women
stay longer in stage 3 and stage 4 phases and
complain of difficulty in falling asleep after
mid sleep awakenings. Men are more likely
to have day time sleepiness than women. [21]
Sleep patterns in women are influenced by
menstrual activity, [22, 23]
pregnancy and
post-partum period. [24-29]
Sleep Deprivation
Sleep deprivation is commonly
referred as inadequate quality and/or
quantity of sleep. It may happen consciously
owing to the demands in meeting work
targets, nature of job, shift duties, mobile or
internet addiction and lifestyles like late
night social engagements etc. It may also
result from primary sleep disorders and
different disease conditions that affect sleep.
Sleep deprivation may result from
shorter duration of sleep as well as from
reduced depth of sleep. Repeated
interruptions during sleep results in
incomplete NREM and or longer REM
phases. Poor quality of sleep allows
inadequate rest to the body and mind and
cause physical fatigue, lack of attention and
concentration resulting in increased risk of
road traffic accidents and mood swings etc
on the successive day. [30]
Chronic sleep
deprivation results in many physical and
mental disorders as explained below.
Common causes of chronic sleep
deprivation
Sleep related breathing disorders
(Obstructive sleep apnea, Central sleep
apnea, Obesity hypoventilation syndrome
etc,), Primary sleep disorders (Sleep talking,
Sleep walking etc,), Neurotransmitter
imbalances (e.g., Schizophrenia,
Depression, Attention deficit, Anxiety
disorders etc.),Concurrent medical
conditions (e.g., Connective
tissue/Rheumatological diseases, Diabetes,
Hypertension, Cardio vascular diseases,
Cancer etc.), Commonly used medications
(e.g., Alpha blockers, Beta blockers,
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 371
Vol.7; Issue: 5; May 2017
Corticosteroids, SSRI Antidepressants, ACE
inhibitors etc.),Psychiatric issues (e.g.,
Stress, Anxiety, Depression etc.) and
Environmental factors (e.g., Food,
Relationships, Type of job, Sleep
Environment etc.) [31]
are some of the
conditions commonly associated with sleep
deprivation
Adverse effects of sleep deprivation
Stress and Anxiety
Anxiety and Sleep deprivation are
risk factors to each other.
Population based surveys indicate
that the prevalence of anxiety disorder is
about 24% to 36% in subjects with insomnia
complaints. [32, 33]
Research on the working population
of USA and European Union shown that
work related pressure is the main source of
stress resulting in sleep disturbances. [34]
Stress and anxiety cause sleep
deprivation and lack of sleep induces further
stress. This precipitates a self perpetuating
vicious cycle. [35, 36]
Feeling restless, anxious and
overwhelmed is a common symptom of
daily stress in developed society. Stress runs
in autopilot mode. One assumes it’s a way
of life. The modern society endorses the
demand of a constant 24/7 active lifestyle
which is characterized by speed, overload of
stimuli, multitasking and being available all
the time. This leads to persistent sleep wake
difficulties.
Depression
Sleep deprivation and depression
aggravate each other.
In epidemiological samples
examining insomnia and depression, 80% of
the depressed persons had at least one
insomnia symptom compared with 36%
who did not have depression. [37]
In many cases, sleep disturbance is
one of the first symptoms of depression.
Patients with depression have difficulty in
initiating and maintaining sleep. [38, 39]
In patients recovering from
depression, if sleep disturbances persist,
there was a significant increase in relapse
and recurrence of depression. [40, 41]
Obesity
Obese people are more likely to
suffer from sleep disturbances and chronic
sleep deprivation leads to obesity. This
bidirectional risk is observed across all age
groups. [42-48]
Persons with shorter sleep duration
of less than six hours were 7.5 times more
likely to have a higher body mass index
(BMI) than those who sleep longer. [49]
Insomnia was associated with lower levels
of leptin (a hormone produced by adipose
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 372
Vol.7; Issue: 5; May 2017
tissue that suppresses appetite) and higher
levels of ghrelin (a peptide that stimulates
appetite). [50, 51]
This hormonally mediated
increase in appetite appears to be the main
factor contributing to obesity in patients
with insomnia. [52]
Diabetes
As diabetics are known to have
frequent sleep disturbances, chronic sleep
deprivation is also a risk factor for insulin
resistance.
Men with sleep deprivation have an
increased risk of age-adjusted Type 2
diabetes. [53]
Sleeping pills increase the risk
of diabetes. [54]
Research shows that approximately
one third of type 2 diabetes patients
experience poor sleep compared with
healthy individuals. [55]
Nocturia and
polyuria in these patients are the main
causes of disturbed sleep. [56]
Obese people
with inadequate and fragmented sleep, have
high prevalence of insulin resistance. [57]
Cardiovascular system
Chronic sleep deprivation is a risk
factor for cardiovascular disease and
cardiovascular patients generally suffer
from poor quality of sleep.
Sleep deprivation is directly linked
to cardiovascular disease - including
atherosclerosis, hypertension and risk of
coronary artery disease. [58]
Rise in blood
pressure due to lack of sleep at night persists
during the following day. [59]
This risk
appears to be more in women probably due
to their associated higher emotional stress. [60]
Acute sleep loss of 3 to 4 hours a night
resulted in marked increase in blood
pressure in men providing association
between sleep deprivation and cardio
vascular risk. [61, 62]
There is high prevalence of sleep
disturbances among people with
cardiovascular disease, adding the risk of
hypertension and sudden death during sleep. [63]
Good quality sleep prevents the risk of
cardio vascular diseases. [64, 65]
Cancer
Interaction between sleep deprivation and
cancer is bidirectional.
In general, the traumatic experience
of cancer diagnosis and its treatment causes
a negative impact on sleep quality. Along
with fatigue, depression and cognitive
impairment, sleep disturbance is also an
important factor compromising the quality
of life in these patients.
19-30% of cancer patients reported
sleep problems continuing for several years
after diagnosis in different studies. [66, 67]
Insomnia is an important indicator of
cancer related fatigue. [68]
Sleep
disturbances may also result as a side effect
from the poly pharmacy of cancer treatment. [69]
Sleep related problems are much
distressing and it is not addressed properly
in cancer management. [70-72]
Association between sleep
deprivations and various cancers such as
breast, colorectal, prostate and endometrium
were found. [73-77]
Individuals getting sleep
of less than 6 hours have 50% risk for
development of colorectal cancer compared
with those who slept for more than 7 hours. [78]
Sleeping for shorter duration in night
as a result of evening and full night shifts in
individuals shown increased risk of
developing prostate cancer compared with
non shift individuals. [79-84]
Sleep deprivation associated with
working in night shifts results in decrease in
melatonin secretion. [85,86]
Melatonin
depletion has significant association in
developing a breast cancer. [87]
Studies
revealed that development of breast cancer
risk is higher in women who are working in
evening or full time night shifts. [88, 89]
Immune system
In acute infections, both total sleep
time and the duration of slow wave sleep
(stage 3 and 4) are increased to facilitate a
positive immune response and healing.
Disturbances in sleep cycle during this
phase can delay recovery and wound
healing. [90]
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 373
Vol.7; Issue: 5; May 2017
In sleep deprived individuals there is
down regulation of T-cell functions and up
regulation of pro inflammatory cytokines
like IL-1, IL-6, and TNF-α, indicating a
response to acute stress and impaired natural
immune mechanisms. [91]
Sleep deprivation impairs the
development of body’s immune response
after vaccination. [92]
Chronic sleep
deprivation results in pro inflammatory state
that is the main precursor of most of the
lifestyle diseases like obesity, diabetes,
arthritis, cardiovascular disease, cancers etc.
In healthy individuals, white blood
cell count increases during deep sleep
indicating body’s readiness to combat
infection. [93]
Good sleep is required to conserve
body’s energy and other resources required
to mount an immune response and fight
disease. [94]
Loss of productivity, early aging and
premature death
Sleep deprivation causes fatigue,
mood disturbances, emotional stress and
burnout [95-97]
eventually resulting in loss of
productivity on the long run.
Insufficient sleep negatively affects
skin health causing fine lines, uneven
pigmentation and impaired skin elasticity
leading to premature ageing. [98]
Poor quality of sleep raises the risk
of accidents while driving and at workplace.
Chronic sleep deprivation is directly linked
to the development of anxiety, depression,
obesity, hypertension, heart disease,
diabetes, cancer etc, also causes impaired
immunity and delayed wound healing,
ultimately laying a path to premature death. [99, 100]
Fundamentals of Heartfulness Meditation
Heartfulness Meditation is resting
the mind on the Heart with one single
thought and ignoring all other thoughts - as
uninvited guests. Regular practice of this
very act trains the mind to pursue only the
necessary thoughts and ignore the unwanted
ones. This is the true regulation of mind
where the mind is guided by the Heart and
there is no cluttering of unwanted thoughts
in the mind. [101]
Heart is the seat of Intellect and
wisdom. Connecting to the depth of heart
develops sensitivity, emotional strength and
a connection to one’s inner self. [102]
The Heartfulness technique for
rejuvenation of mind by removing deep
impressions through autosuggestion is
useful to remove mind clutter. [103]
Burden of emotional stress remains
as long as thoughts remain in touch with the
physical mind. With this state of mind, one
needs longer time to fall asleep and gets, if
at all, only a disturbed sleep. Deep
meditation on the heart takes the mind into
the finer layers of consciousness, physical
awareness is lost, and the traffic of
unwanted thoughts causing emotional stress
is automatically removed. Sleep will be
instantaneous, deep and undisturbed for a
balanced mind that is trained through
regular meditation. [104]
Positive effects of Meditation on Sleep
Relaxation response
During sleep, there is reduction in
Heart rate, blood pressure, respiratory rate
and minute ventilation and there is
decreased oxygen consumption and carbon-
dioxide elimination leading to a hypo
metabolic state with no change in
respiratory quotient. [105]
Meditation induces similar
physiological changes except that the person
remains alert although the physical body
goes into a state of deep relaxation. It is a
wakeful hypo metabolic state with
parasympathetic predominance termed as
the Relaxation response. [106]
Enhancing Melatonin
Meditation augments synthesis of
melatonin in the pineal gland, a hormone
that regulates natural sleep cycle. [107,108]
Stress inhibits the production of melatonin. [109]
Risk of breast cancer is linked to the
reduction in melatonin levels due to sleep
deprivation. [85, 86]
Meditation, by enhancing
melatonin levels, prevents this risk. [87-89]
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 374
Vol.7; Issue: 5; May 2017
Soon after beginning a meditation
practice, many people have reported better
quality of sleep as well as needing less
sleep. [110]
Alleviating Anxiety and depression
Meditation induced regulation of
mind directly reduces anxiety and
depression. [111-114]
This effect is noted in
both beginners and advanced meditators.
Brainwaves get stimulated in the same way
during both meditation and deep sleep, from
boosting the Alpha, Theta and Delta waves
and reducing the stress associated beta
waves. [115]
Positive effects on comorbidities that
affect sleep
Meditation has proven benefits in
the prevention, treatment and rehabilitation
of Hypertension, Ischemic heart disease,
Bronchial asthma, COPD, Anxiety neurosis,
Depression, Cancer, Certain degenerative
diseases and many chronic pain conditions. [116-119]
Sleep disturbances are common in
these conditions which are also improved by
meditation.
Meditation also influences the
cognitive behavioural [120, 121]
and emotional
aspects [122-125]
in these patients, thus
improving their overall prognosis.
Decluttering the mind and relieving stress
According to National Science
Foundation, our brain produces 50,000
thoughts per day. [126]
Ninety-five per cent
of these thoughts are repetitive, restrictive,
spiral of anxieties and worries about the past
and future. Even though the body is at rest
the mind cannot unwind itself. This is the
fundamental cause of stress leading to sleep
disturbances. [127]
Training our minds to
meditate by ignoring thoughts brings us to
the awareness of the present and creates a
balanced state within, thereby removes
stress. [128]
The practice of retaining the
meditative state throughout the day, as we
go about with our activity further inhibits
the development of stress. [129]
Meditation before sleep hours
removes tangled thoughts, prepares the
mind to connect deep within and leaves one
in a state of calmness and surrender. [130]
Meditative practices thus help to
integrate the brain functions, regulate the
various physiological mechanisms resulting
in a state of mental, emotional and physical
well-being. [131]
CONCLUSION
Sleep is a significant component of
life that is essential for rejuvenating body
and mind on a daily basis. Sleep related
problems are growing in the current times
due to modern day lifestyles.
Insufficient sleep, both in quality or
quantity, causes many adverse effects on the
physical and mental health and can lead to
premature aging and death.
Meditation shortens time required to fall
asleep, enhances the depth of sleep and
improves overall quality of sleep.
Positive effects of Meditation on
sleep are established by its relaxation
response on the body, by decluttering the
mind - thereby relieving anxiety, depression
and stress and by enhancing melatonin
levels. Meditation also improves outcomes
of many disease conditions that could
negatively affect sleep and thus relieves
sleep deprivation resulting from them.
Method of meditation and systematic
practice are crucial to gain the best.
Simplified heart-based raja yoga
meditation techniques, like Heartfulness,
designed to suit modern day hectic life with
their holistic approach, are effective in
Raja Amarnath et al. Improving Sleep Quality through Heartfulness Meditation- Technical Aspects and Benefits
International Journal of Health Sciences & Research (www.ijhsr.org) 375
Vol.7; Issue: 5; May 2017
improving sleep and quality of life, when
practiced regularly. Source(s) of support: Self funded
Conflict of interest: Declared none
ACKNOWLEDGEMENT
We acknowledge sources for the represented
images.
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How to cite this article: Amarnath R, Verma G, Jenitha S et al. Improving sleep quality through
Heartfulness meditation- technical aspects and benefits. Int J Health Sci Res. 2017; 7(5):368-381.